The influence of prior oral contraceptive use on risk of endometriosis is conditional on parity

Oral contraceptive pill use is associated with a higher risk of future endometriosis diagnosis in nulliparous women but a lower risk among parous women.

Like Comment

Authors

Frank Tu, M.D., M.P.H., Hongyan Du, M.B., M.S., Gregory P. Goldstein, M.D., Jennifer L. Beaumont, M.S., Ying Zhou, Ph.D., Wendy J. Brown, Ph.D.

Volume 101, Issue 6, Pages 1697–1704

Abstract

Objective:

To estimate the influence of prior oral contraceptive pill (OCP) use on future diagnosis of endometriosis in young women.

Design:

Prospective cohort study, the Australian Longitudinal Study on Women’s Health.

Setting:

Community-based sample.

Patient(s):

9,585 women age 18–23 at study onset.

Intervention(s):

None.

Main Outcome Measure(s):

Risk of self-reported endometriosis estimated with Cox proportional-hazards regression with time-dependent covariates.

Result(s):

Compared with never users, endometriosis hazard ratios in nulliparous women with <5 years and ≥5 years of OCP use (preceding diagnosis) were 1.8 (95% CI, 1.30–2.53) and 2.3 (95% CI, 1.59–3.40), respectively. Similar risk was seen in both women reporting infertility and unsure fertility. In parous women with <5 years of use, the hazard ratio for endometriosis was 0.41 (95% CI, 0.15–0.56) and for ≥5 years of use was 0.45 (95% CI, 0.16–1.23). Women reporting early noncontraceptive OCP use had a twofold higher risk (odds ratio 2.07; 95% CI, 1.72–2.51). Conclusion(s):

Prior OCP exposure reduces the risk of diagnosis of endometriosis in parous women but increases it among nulliparous women; these associations appear unaffected by fertility status. An increased risk of endometriosis diagnosis seen in women reporting early noncontraceptive OCP use may explain some of the positive OCP risk seen in nulliparous women.

Read the full text at: http://www.fertstert.org/article/S0015-0282(14)00152-6/fulltext


Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

No comments yet.